Title:New Imaging Tracers for the Infected Diabetic Foot (Nuclear and Optical Imaging)
Volume: 24
Issue: 12
Author(s): Alfred O. Ankrah, Hans C. Klein and Philip H. Elsinga*
Affiliation:
- University of Groningen, University Medical Center Groningen, Department of Nuclear Medicine and Molecular Imaging, Groningen,Netherlands
Keywords:
Optical imaging, radiopharmaceuticals, diabetic foot infections, nuclear medicine, osteomyelitis, SPECT/CT, PET/CT, bacteriaspecific
imaging.
Abstract: Diabetic Foot Infections (DFIs) are associated with increased morbidity, an economic burden on patients,
their families and healthcare systems and increased mortality. Early diagnosis with prompt, appropriate and
adequate treatment of the infected diabetic foot is crucial. The determination of DFIs, however, may be quite
perplexing and invasive. Imaging is useful in the evaluation of certain cases of DFIs, especially in suspected
instances with no overt clinical features, or in the diagnosis of osteomyelitis. Nuclear medicine imaging is currently
used in the evaluation of DFIs; however, like all the imaging techniques now available, it has its limitations.
Several radiopharmaceuticals presently available play useful roles in the management of DFIs, while new
ones are being evaluated. Optical imaging techniques have recently demonstrated promising results in the evaluation
of many infections including DFIs. Using the same molecule, a tracer can be labeled with a radioisotope or
an optical imaging dye. This enables infections to be evaluated both pre- and intra-operatively when surgery is
required in their management. In some cases, tracers have been simultaneously labeled with both a radioisotope
and an optical imaging dye to produce a hybrid tracer. These new tracers potentially provide powerful and new
opportunities in the management of DFIs. In this review, we briefly examine tracers that have been used in the
evaluation of the infected diabetic foot. We then explore the potential of new imaging tracers currently under
development for infection that may be useful in the management of DFIs.
